HomeMy WebLinkAboutR2020-0301 - Permit ApplicationRBR#
City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT , :ovsro n
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658=89161"'"'
www.newportbeachca.gov 1 (949) 644-3200 l,:vrs FMEra"
MAR 17 2020
Application for Report of Residential Building Recordsr{)r
Application Fee: $191.00 Notice: Applicatiois'Wit,40ps4ffi lent fee
payment
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units:_1 Address:436 De Sola Terrace City: Newport Beach( Corona Del Mar Area) State: CA Zip:
92625
Property Owner: Douglas E Godbe Administrator of the Estate of Selina Bel Smith
Owner Address: - City:
State: Zip Code: - Home Phone:
Owner's Authorized Agent: Casey Lesher Work Phone:
Agent Address: 840 Newport Center Dr. #100, City: Newport Beach State: CA
Mobil Phone: - Agent Email Address: caseyleshe(ogmail.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive Suite 200
State: CA Zip Code: 92660
Email Report To: djohnson@marinersescrow.com
For Inspection Call (Name):
Escrow # 57978 -DJ
City: Newport Beach
Zip Code: 92660
Escrow Phone: 949-640-6040
Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
I authorize inspections and re -inspections of the property listed above. I understand that if Building or Zoning
violations are discovered I will be responsible to correct said violations.
Owner or Agent's signature to authorize inspection
Owner or Agent's signature to decline
Account #
OR
checks payable to CITY OF NEWPORT BEACH
C� � A4 V' Lv� vnCwl v vS �SLyZ)vJ , vim
J4 c , L,